The ruling relations of patient involvement in cardiac rehabilitation programs

Patient involvement has often been defined and examined on the basis of conceptual theoretical frameworks. This article explores patient involvement contextually and locally, in encounters between patients and healthcare professionals in cardiac rehabilitation in Denmark. With inspiration from institutional ethnography, the goal is to unpack what involvement actually implies in rehabilitation activities. The analysis provides micro-sociological insights into how patient involvement is constituted and institutionally conditioned and shows how textually mediated ruling relations regulate activities and interactions, shaping patient involvement in local practices. The analysis reveals how patient involvement primarily relates to healthcare professionals involving patients in health knowledge. It explores how national guidelines and local instructions for healthcare professionals frame understandings of patient needs and problems. The concluding discussion highlights how patients have limited opportunities to influence their own care process. It also points out how it is left to the individual healthcare professional to solve contradictions between institutionally defined tasks and the ambition of patient involvement.

Ruling Relations and the School Librarian An Institutional Ethnography

The work of a school librarian is shaped by relations seen and unseen. Problematizing the effects of these relations on the institutions of education, librarianship, and school librarianship can lead to a greater understanding of the work of the librarian. I will use institutional ethnography methods to investigate relations of education, librarianship, and school librarianship Institutional ethnography has been used to investigate the coordination of activities in other human services, but institutional ethnography has not yet been applied intensively in educational settings (Smith, 2005). Institutional ethnography can be used as a method of inquiry into the work of people in educational settings.

Towards a Decolonizing Framework for Pre-Departure Education

In light of the increasing mobility of people for study and employment purposes and the fact that Indigenous groups continue to be marginalized across the globe, this article introduces a tentative framework for adult educators or facilitators to decolonize their pre-departure orientations for workers or learners who plan to live in a different country. Drawing on Indigenous education principles, the framework consists of three guiding principles that intersect with one another: (1) Indigenizing teaching practice, (2) deconstructing ruling relations, and (3) promoting reflexivity, mutual respect, and understanding. Challenges to implementing this framework include organizational requirements to maintain a Western dominance in their pre-departure programs.